Tendons are connective tissue structures that attach muscles onto bone. Tendon injuries can cause significant pain and loss of function.
Tendons are most often injured through overuse, when they are repetitively loaded incorrectly or overloaded and not allowed to adequately recover. This often occurs when starting a new exercise program or changing exercise habits. Tendons are often injured in repetitive movements completed at work or in our daily activities. A direct impact or blow can also cause a tendon injury.
Commonly tendon pain is present as you start exercising or moving, disappears once you are warmed up, then returns upon cooling down. Pain often comes on more severe after exercise or the following morning. Common tendon injury sites are the Achilles, knee, elbow and shoulder.
Causes of Tendon Pain
Types of Tendon Injuries
Reactive: This is an acute injury, commonly seen in younger populations, caused by:
Reactive on Degenerative: This is an acute exacerbation or flare up of a chronic tendon injury and may be caused by an increase in activity or training load.
Tendon Rehab is Different
Unlike many other injuries, tendons must be loaded to repair and heal. While initially it may be required to reduce activities that overload the tendon, rest is not recommended. Rehabilitation consists of load management, to safely and slowly increase the load on the tendon, allowing the tissue time to adapt and heal.
What can BeachLife Physio do to help?
If you have any concerns or need advice on any of the above please do not hesitate to call us to book an appointment on 9970 7982, or book online.
Rees, J.D., Maffulli, N., Cook, J. (2009) Management of Tendinopathy, Am J Sports Med, 37(9):1855-67.
Voleti, P.B., Buckley, M.R., Soslowsky, L.J. (2012) Tendon healing: repair and regeneration, Annu Rev Biomed Eng, 14:47-71.
The number of older people falling is increasing annually in Australia. Each year one third of people aged over 65 years experience a fall, with older women being most at risk. Unfortunately, as we get older we are more likely to sustain a fall that can have a serious impact on our health, living situation and our families.
Why do People Fall?
Many factors such as physical, psychological, social and environmental factors can contribute to or cause a fall. A few of the most common predictors of falls include:
The Impact of Falls
Falls are one of the leading reasons for hospital admissions in older people. Injuries range from bruises and lacerations to hip fractures or traumatic brain injury. Fractures occur in 10-15% of falls and other serious injuries requiring medical admission occur in 15-20%. Falls are the strongest risk factor for fracture, more so than osteoporosis!
Falls can also have a significant impact on the social and psychological wellbeing of the individual. A person will often feel vulnerable, fearful and hopeless after a fall. This can impact their confidence in their mobility or their living situation and can also impact their ability to function in the home environment and the community.
Less than half of older patients who fall tell their clinician about it due to embarrassment or a disregard of the significance of the fall. If you or someone you know has had multiple falls or a fall that makes you concerned, it is strongly recommended that you seek advice from your GP, occupational therapist or physiotherapist.
How Can BeachLife Physio Reduce Falls Risk?
Firstly, we are able to assess for possible causes of the falls such as weakness of specific muscles, reduced sensation and specific balance testing. Our physios then use this information to prescribe an appropriate program which can include any of the following:
As well as reducing falls, exercise helps to improve well being, has positive impacts on cardiovascular disease, diabetes, and helps fight depression, dementia and cancer.
At BeachLife Physio we can assess and prescribe a balance program in the clinic but we also offer home visits on the Northern Beaches and Northern Suburbs of Sydney to assist people at risk of falls and help them maintain their lifestyle. If you have any concerns or are interested in a falls assessment, please call us on 9970 7982.
Assess Your Balance
Below are two tests that you can use to assess your balance. Difficulty with either of the tests indicates that you are at an increased risk of a fall.
Please only attempt these tests if it is safe for you to do so. Position yourself near something to hold in case you need it; a bench, table or wall. If you are unsure about your ability, ask someone to stand close for supervision. Start with tandem stance, as this is easier, and only if you are able to do this easily, should you attempt single leg balance.
Thank you to Susan for modelling great balance!
If you have difficulty with balance, have experienced a fall and are concerned about your risk, or need advice on any of the above please do not hesitate to call us to book an appointment on 9970 7982, or book online.
Järvinen, T. Sievänen, H., Khan, K., Heinonen, A. and Kannus, P. (2008) Shifting the focus on fracture prevention from osteoporosis to falls , BMJ, 336(7636):124-6.
Levinger, P., Wallman, S., Hill, K. (2012) Balance dysfunction and falls in people with lower limb arthritis: factors contributing to risk and effectiveness of exercise interventions, European Review of Aging and Physical Activity, 9(1): 17-25.
Mancini, M. and Horak, F. (2010) The relevance of clinical balance assessment tools to differentiate balance deficits, Euro J Phys Rehabil Med. 46(2): 239-248
Martin, F.C. (2011) Falls risk factors: assessment and management to prevent falls and fractures, Can J Aging, 30(1): 33-44.
Moncada, L.V. (2011) Management of falls in older persons: a prescription for prevention, Am Fam Physician, 84(11): 1267-76.
Nowak, A., Hubbard R.E. (2009) Falls and frailty: lessons from complex systems, J R Soc Med. 102(3): 98-102.
Paul,S., Harvey, L., Carroll, T., Li, Q., Boufous, S., Priddis, A. (2017) Trends in fall-related ambulance use and hospitalisation among older adults in NSW, 2006–2013: a retrospective population-based study, Public Health Res Pract, 27(4):e27341701.
Toulotte, C., Thevenon, A., Watelain, E. and Fabre C. (2006) Identification of healthy elderly fallers and non-fallers by gait analysis under dual-task conditions, Clinical Rehabilitation, 113, 767-777.
Waldron, N., Hill, A.M., Barker, A. (2012) Falls prevention in older adults - assessment and management, Aust Fam Physician, 41(12): 930-5.
One of the most devastating injuries for the active sporting population is an anterior cruciate ligament (ACL) rupture. This is a complete tear of one of the important ligaments that maintains knee joint stability. A rupture of the ACL can cause significant initial pain and requires a lengthy rehabilitation process. The majority of people require surgery for a full recovery. This blog outlines the risk factors for an ACL injury and how we can work with you to reduce your risk.
Firstly, it’s important to appreciate the huge potential for preventative measures to protect the ACL from injury. It has been found that 60-80% of ACL ruptures occur in non-contact situations. This means that the injury is a result of poor muscular control and biomechanics rather than the influence of an unexpected external force (such as a tackle from an opposing player, which would be considered a contact injury). This means we have control over the main factors leading to ACL injury. Through specific exercises we can influence muscular control and biomechanics for the better.
Assessing your risk
ACL injuries are common in field and court sports, and other sports that require running with fast changes of direction, combined with jumping and landing.
The typical mechanism of a non-contact ACL rupture is a forceful movement of the leg rotating inwards and the foot collapsing, causing the knee to twist forcefully inwards.
A simple test to assess your risk of getting into the position is the lateral step-down test. Start from an elevated height such as a step and step down with one foot. As you descend you may notice that your knee rotates in. This may become more apparent in a more dynamic movement, just as in sport, such as hopping down from the step and assessing whether your knee rotates inwards as you land. This is easiest to assess if you get someone else to video you, so you can watch from the front. If you complete these tests and the knees move into this risky position, there are a few factors to address. If your positioning is good with the knee staying in line with the hips and foot, this indicates you have a decreased risk (but definitely not no risk) of ACL injury.
Causes of poor knee control
There are two common mobility issues that cause the knee to move into this position. Inadequate hip and ankle mobility are commonly compensated for by rotation of the leg.
From a strength perspective it is weakness in the glutes and hamstring muscles that increases your risk of ACL injury. The glutes control rotation movements of the leg and stabilise when standing on one leg. They therefore have a big influence as to whether your knee has a tendency to rotate inwards into the dangerous position for ACL injury. The hamstrings have the ability to reduce the forward movement of the lower leg on the upper leg, which is the other common factor in ACL injuries.
Reducing your risk - what can BeachLife Physio do?
Mobility and strength tests performed by your physiotherapist can differentiate which of the above is the cause of your poor knee positioning and control. We then provide the appropriate strength and mobility exercises to decrease your risk of injury. This is best completed early in the off season of your sport, to ensure you are prepared for your sport once the season starts!
If you have poor knee control, want to reduce your risk of injury, or need advice on any of the above please do not hesitate to call us to book an appointment on 9970 7982, or alternatively book online.
Norcross, M. F., Halverson, S. D., Hawkey, T. J., Blackburn, J. T., Padua, D. A. (2009) Evaluation of the Lateral Step-Down Test as a Clinical Assessment of Hip Musculature Strength. Athletic Training & Sports Health Care, vol. 1, iss. 6.
Yonz, M. C. Robertson, K. E., McKinley, R. et al. (2016) Relationship of Hip and Trunk Muscle Function with Single Leg Step-Down Performance: Implications for Return to Play Screening and Rehabilitation. Physical Therapy in Sport, vol 22, pp. 66-73.
The ankle joint is very commonly injured in the active population. In sports such as rugby, AFL and hockey, an ankle sprain is the most common ankle injury. Ankle sprains are commonly referred to as a ‘rolled’ or ‘twisted’ ankle.
What is an ankle sprain?
Surrounding all our joints are ligaments that connect our bones and protect the joint by limiting excessive movement. An ankle sprain is when the joint is moved forcefully to the end of the available range and one or more of the ligaments gets overstretched, resulting in damage. There are 3 grades of ligament sprain; grades 1-3. These are diagnosed according to the severity of the damage, with grade 1 being minor damage and grade 3 being full rupture of the ligaments.
Types of Ankle Sprains
Mechanism of Injury
Most people sprain their ankle when walking and running on uneven surfaces or in sport when accidentally landing or standing on something, such as uneven ground or an opponent’s foot. The most common way to sprain an ankle is to roll onto the outside aspect of the ankle joint, causing a lateral ankle sprain.
Signs and Symptoms
The ankle will be painful, swollen and occasionally bruising will come up around the joint. It may be painful to take steps and the ankle is often reported as feeling unstable. In severe sprains people are unable to put weight through the injured foot.
Ankle Sprain Management
The first important step is to ensure that there is no fracture – if there is significant pain and an inability to place weight through the foot, then a visit to the hospital emergency department is recommended. Otherwise when your physio assesses the ankle in the clinic they will determine whether imaging is required and refer appropriately.
Of people who experience an ankle sprain and do not manage their symptoms appropriately, 70% will experience long lasting symptoms. Therefore, it is important to take your ankle sprain seriously. In a recent review of the literature, it was found that most management approaches are too short in duration, and unless treatment is tailored to the severity of the ankle sprain, most people will have lingering symptoms. However not surprisingly, having at least some treatment was more effective than a ‘no treatment’ approach in ankle sprain management.
Stages of Rehabilitation
Acute (approx. 0 - 10 days)
What to expect from us
Booking an appointment with us in the first few days post injury is very important to protecting your sprain appropriately. Then physio is important to complete the correct rehabilitation and get you back to activity safely and then reducing the risk of re-injury in the long term.
Your first physiotherapy appointment will involve:
If you have had multiple ankle injuries or experience chronic ankle instability, physio can help! The treatment is very similar to an acute sprain, without the initial care following after an acute injury.
If you have an acute ankle injury, want to reduce your risk of injury, or need advice on any of the above please do not hesitate to call us to book an appointment on 9970 7982, or alternatively book online.
Dijk van, C.N., Mol, B.W.J., Marti, R.K., et al. (1996). Diagnosis of ligament rupture of the ankle joint. Physical examination, arthrography, stress radiography and sonography compared in 160 patients after inversion trauma. Acta Orthop Scand, vol. 67, pp. 566-70.
Fong, D. T. P., Hong, Y., Chan, L. K., Yung, P. S. H., & Chan, K. M. (2007). A systematic review on ankle injury and ankle sprain in sports. Sports Medicine, vol. 37, iss. 1, pp. 73-94.
Kannus, P., Renström, P. (1991) Treatment for acute tears of the lateral ligaments of the ankle. Journal Bone Joint Surgery [Am], vol. 73, pp. 305-12.
Pijnenburg, A.C.M, Dijk van, C.N., Bossuyt, P.M.M., et al. (2000). Treatment for lateral ankle ligament ruptures: a meta-analysis. Journal Bone Joint Surgery [Am], vol. 82, pp. 761-73.
The application of ice or cold packs are a very common treatments used to manage an acute injury or to help with muscle recovery. Originally it was believed that ice therapy reduced pain, swelling and helped with recovery from injury. However, recent studies have challenged the original theories behind the benefits.
How does ice work and how helpful is it?
Ice applied to the skin slows and reduces the activity of the nerves in the area, which then decreases the pain sensation. Several studies have found that following a soft tissue injury, such as a hamstring strain, or joint replacement surgery the use of ice significantly reduced pain. However, it is important to note that these studies found that function and recovery were not improved.
In the first few days after joint replacement surgery it is crucial to improve range of movement at the joint. Ice therapy in conjunction with pain medication is used to allow for range of motion exercises to be completed with minimal pain.
The theory behind using ice therapy for swelling is that the cold temperature causes our blood vessels to constrict, resulting in reduced blood flow to the region. New evidence has found that the cold does not penetrate deep enough for this effect to occur and therefore ice does not reduce swelling.
More effective ways to reduce swelling include:
Compression - Compression bandaging or taping to prevent the swelling from accumulating.
Elevation - Positioning the injured area raised up to allow the excess fluid to drain with gravity.
Cold Water Immersion
Athletes often use cold water immersion to assist with muscle recovery during periods of intense competition. Immersion in cold or iced water causes an increase in heart rate, blood pressure and metabolism, as well as increasing the amount of air we expire. However, the role of these in recovery are still unknown. While it is thought that these factors may help flush out toxins in the muscles that are caused by intense exercise, there is no evidence to support this. There is some evidence that cold water immersion reduces delayed onset muscle soreness (DOMS) and reduces athletes perception of general fatigue and leg soreness.
Risks of Using Ice Therapy
There are risks you need to be aware of when using ice therapy. When placing ice on the skin, there is potential for an ice burn. This is more likely to occur with direct contact on the skin for an extended period. For this reason, avoid the ice being in direct skin contact (use a thin towel in between) and do not apply for longer than 20 minutes at one time.
When using cold water immersion, be aware that a significant change in body temperature can cause shock in some people. Athletes should be supervised at all times by someone with first aid qualifications to ensure that any symptoms of shock can be dealt with immediately. Shock if left untreated can be life threatening.
Overall, ice therapy and cold water immersion may be useful for reducing pain and there are relatively low risks associated with its application. However, elevation and compression are more effective to manage swelling.
The application of ice, compression and elevation are just the initial phase of injury management. To ensure return to full function, appropriate assessment, treatment and rehabilitation is essential.
If you need treatment for an injury or advice on any of the above, please do not hesitate to call us to book an appointment on 9970 7982, or alternatively book online at beachlifephysio.com.
Adie, S., Kwan, A., Naylor, J., Harris, I. and Mittal, R. (2012) Cryotherapy following a total knee replacement, Cochrane Database of Systematic Reviews.
Bleakley, C. and Davison G. (2010) What is the biochemical and physiological rationale for using cold-water immersion in sports recovery? A systematic review, British Journal Sports Medicine, 44(3): 179-187.
Crystal, N., Townson, D., Cook, S., LaRoche, D. (2013), Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise, European Journal of Applied Physiology.
Kullenberg, B., Ylipää, S., Söderlund, K. and Resch S. (2006) Postoperative Cryotherapy After Total Knee Arthoplasty: A Prospective Study of 86 Patients, The Journal of Arthroplasty, 21(8), 1175-1179
Rowsell, G., Coutts, A., Reaburn, P. and Hill-Haas, S. (2009) Effects of cold-water immersion on physical performance between successive matches in high-performance junior male soccer players, Journal Sports Science, 27(6): 565-73.
Nearly all of us have experienced headaches. Headaches are the most common neurological disorder with up to 1 adult in 20 experiencing one every day. When they occur repeatedly, they are a symptom of a headache disorder, which are painful and disabling.
Common types of headaches
Tension headaches are the most common type of headache and can be caused by a number of factors, including stress, fatigue, emotional upsets as well as poor posture or jaw clenching.
The symptoms of tension headaches include a constant tight, heavy or pressing sensation around the head, generalised and diffuse pain. The pain is usually felt on both sides of the head.
Cervicogenic headaches stem from the uppermost joints of the cervical spine (neck). If these joints have extra load through for example from poor posture they can get aggravated or stiff and cause headaches. Other neck disorders such as whiplash or osteoarthritis may also be a cause for these headaches.
The symptoms of cervigogenic headaches are often one sides and include reduced neck movement or increased stiffness, pain that is usually non throbbing or radiating and may begin just as a pain or heaviness in the neck.
Migraines affect at least 1 in 7 adults. They do not have a single, simple cause. Factors vary from person to person and there is need for further research into why they occur. Some triggers include hormonal changes, genetics, stress, medications and altered sleeping patterns.
The symptoms of migraine headaches include a throbbing or pulsating intense pain, with sensitivity to light or noise and sometimes comes with nausea or vomiting.
But if it’s my neck, why is there pain in my head?
The nerves in the upper neck interact with the sensory nerves that supply the neck and face such that it allows for a two way flow of painful sensations. Thus pain and reduced mobility in the neck is felt in the head.
What can BeachLife Physiotherapy do to help?
Physiotherapy can reduce the severity and frequency of headaches and also assist in long term management to reduce frequency and intensity of flare ups. This will be achieved through:
If you experience headaches or need advice on any of the above, please do not hesitate to call us to book an appointment on 9970 7982, or alternatively book online at beachlifephysio.com.
Biondi, D.M. (2005) Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies, The Journal of the American Osteopathic Association, vol. 105, pp. 16S-22S.
Headache Australia (2018) Headache Types: Tension-type Headache, accessed 7/3/2018, http://headacheaustralia.org.au/headachetypes/tension-type-headache/.
World Health Organisation (2018) ‘How common are headaches?’ accessed 7/3/2018. http://www.who.int/features/qa/25/en/
The start of the winter sports season is fast approaching! Everyone is busy sorting out new uniforms and checking whether their shoes fit; but many of us are not doing anything to prepare our bodies.
Many sports injuries are a result of our bodies not having adequate strength, endurance, coordination or mobility to cope with the activities and sports we participate in. You wouldn't run a marathon without completing a training program, so why wouldn’t you train to run up and down a field for weekend sport? By doing little or no pre-season preparation, you are living up to the adage 'if you fail to prepare, prepare to fail'.
Our muscles, joints and soft tissues can manage a certain amount of load before damage occurs. This is individual and depends on the loads you have exposed yourself to in the past. For example, if you can normally comfortably run 2 km and do this regularly, you know that you can safely do up to 2 km without risking injury. If you don’t exercise regularly and spend much of your week sitting, then participating in sports requires so much more than your average day. For example, the average distance run in a game is:
Due to the added strain on the body you are more likely to injure yourself if unprepared. The common injuries we see in our clinic in the first few months after winter sports start are hamstring tears, Achilles tendinopathy, shin splints, plantar fasciitis, lower back pain, rotator cuff tendinopathies and patella femoral pain syndromes. All of these will occur if your muscles aren’t strong, long or coordinated enough to cope with the sport you participate in.
Training over the pre-season will allow your body to adapt to an increased load and prepare your body for the demands of your sport in the upcoming season. This will not only decrease your risk of injury but will also make you a better player!
How Can You Prepare?
Increase endurance - The majority of winter sports require you to run on and off for prolonged periods. Overuse injuries are caused by increasing your load too much too quickly, with your body unable to keep up! Improving your endurance will decrease the risk. Start building endurance by going for regular runs. Start with a short distance or time and gradually add a small amount until you can run comfortably for the duration of what your sport requires.
Strengthen your core - A strong core is essential for all sports, for lower back health and increased stability and balance. Pilates is a very good way at learning to incorporate your core with everyday movements.
General strengthening – We all have our limits as to what our muscles can handle. For rugby players, the strength needed to go into a tackle can be 5-7 times the strength you would use in your daily activities. To lower your risk of injury, determine the strength that your sport requires and gradually build your training up to this.
Improve proprioception and coordination – During sport, or even doing simple activities such as walking, your brain continually processes sensory information – this is called proprioception. When the ability to interpret and integrate this information into actions is decreased, we are at an increased risk of injury. To help prevent this declining, especially after the age of 25, it is important to continually practice balance and coordination. Start your balance exercises with something as simple as standing on one foot and progress from there.
Increase flexibility – Movements in sport often require you to go to the end of range available at a joint. If your muscles are short and now allowing much movement, you risk an injury to the muscles or joints being over stretched, especially with quick or forceful movements. Stretching the hamstrings will decrease the chances of getting a hamstring muscle tear and keeping your back mobile will decrease the chances of an unusual position in a tackle resulting in pain and injury. For further information on stretching, read our blog titled ‘Stretching 101’.
If you play a winter sport and need advice on any of the above please do not hesitate to book an appointment with us.
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Mangine GT, Hoffman JR, Gonzalez AM, Townsend JR, Wells AJ, Jajtner AR, Beyer KS, Boone CH, Miramonti AA, Wang R, LaMonica MB, Fukuda DH, Ratamess NA, Stout JR. (2015) The effect of training volume and intensity on improvements in muscular strength and size in resistance-trained men. Physiol Rep, vol. 3, iss. 8. pii. e12472. doi: 10.14814/phy2.12472.
Miller T (2013) Which sports run the most? Stats on football, basketball, soccer and tennis show who burn the most shoe leather, New York Daily News, April 4.
The squat is a simple movement, but requires complex interaction between multiple muscle groups to be performed correctly. A small imbalance in strength, control or movement in any area can have a flow on affect impacting other areas.
The squat is a both a great exercise but also a useful assessment tool to highlight areas that may be putting you at risk of injury or holding you back from performing to your potential. For example, your squat technique may indicate that you have poor control of your core muscles. This predisposes you to injury during squatting as well as any other lifting or weighted movements, as well as in sustained postures during your daily activities, work or sport.
While it is best to have your technique assessed by a physiotherapist, there are some common mistakes you can assess and begin to correct yourself. This blog will discuss the two most common dysfunctions seen by physiotherapists and how to begin to correct these dysfunctions to correct squat technique.
Assessing your own squat is difficult, so use a mirror or get someone to observe you completing the movement.
This is best observed from the front. You may find you shift your weight more to one side throughout the squat movement. This increases the risk of overload and injury due to the imbalance of movement.
Unequal weight bearing can result from a number of dysfunctions, but is commonly it is caused by:
Weakness – If the shift occurs early in the movement, this indicates that it is more likely to be caused by weakness in the hip stabilising muscles, the gluteals. This causes a shift to the stronger leg, as your body compensates for the weaker side.
You can start correcting this by completing single leg strengthening exercises. This will highlight the weakness as well as allow you to improve stability and strength. Single leg exercises isolate the weaker side to avoid the stronger side compensating.
Decreased range of motion – If the shift occurs towards the bottom of the movement, it is more likely to be a result of reduced range of motion of the joints in the lower limb. With stiffness in joints, the body shifts to the side with more flexibility or movement available to complete the squat.
This is commonly a reduced range in the ankle, but can also be the knee or hip. Reduced ankle range can be a result of joint stiffness, which needs physiotherapy treatment to be corrected. You can start decrease the effect of short calf muscles on the joint by completing calf stretches.
Incorrect Spinal Posture
The position of the spine is best observed from the side. Throughout the squat movement, the spine should stay in it’s neutral position, from your lower back up to your neck. Commonly the upper back curves and the shoulders hunch forward, also resulting in a forward curving of the lower back. This can lead to a number of issues, including back pain, shoulder injury and tension headaches.
Loss of a neutral spine can result from a number of dysfunctions, but is commonly it is caused by:
Upper back stiffness – A stiffness through the upper back joints results it difficulty getting to and holding an upright posture.
Complete upper back mobility exercises on a roller to ensure that your spine has good movement available.
Upper back weakness – Weakness in the muscles that control posture, the shoulder blades and upper back results in difficulty holding correct posture, especially once weight is added.
Complete ‘pulling’ exercises, such as rows to improve upper back strength and shoulder blade control.
Poor core control – The position of the lower back has a significant impact on the overall spinal position in a squat. A lack of control and stability of the core and trunk muscles translates to a lack of control through the rest of the body.
Core exercises, such as planks, will assist to improve activation and control of trunk stabilising muscles.
While some of these dysfunctions are easy to fix, others are harder to assess and correct. A thorough physiotherapy assessment will identify dysfunctions and provide treatment and exercises to correct them, preventing injuries in the future.
If you notice any of the above during your squats, have pain during squatting, or need advice on any of the above please do not hesitate to book an appointment.
What is Pilates?
Pilates is a popular exercise system developed by Joseph Pilates in the 1920’s to improve strength, flexibility and stability of key muscles in the body. The focus is on correct core activation, isolation of stabilizing muscles and joint stability.
Who benefits from doing Pilates?
Pilates has commonly been stereotyped as only for women. However, all of us would benefit from doing regular Pilates. Everyone needs stability for maintaining good posture (especially those working in desk jobs!), preventing or managing injuries both acute and chronic, as well as improving performance in our chosen sport.
Research has found that Clinical Pilates is effective in reducing pain and disability in several musculoskeletal conditions including low back pain, neck pain and ankylosing spondylosis (a type of arthritis).
What is the difference between Clinical Pilates and Pilates at the gym?
Pilates classes at the gym, run by Pilates instructors, often have 20-25 clients and are a great source of global strengthening and superficial core work. Clinical Pilates classes are run by Physiotherapists for smaller numbers of clients, normally 5-6. This allows closer personalised attention to ensure correct technique and modification of exercises to tailor a program to an individual’s needs. Clinical Pilates is more beneficial for enhancing your deep core activation as well as better for managing specific injuries. If you are new to Pilates, it is recommended to start with a Clinical Pilates program.
What do we REALLY mean by activating your ‘core’?
The ‘core’ is complex. It involves two groups of muscles, one working to stabilise the spine while the other muscles create movement. It is these principles of core activation that underlie the core program in Clinical Pilates.
Why the diaphragm? The diaphragm not only controls our breathing but is directly involved in regulating our abdominal pressure. If we hold our breath, we increase the pressure in our abdomen, providing stabilisation for the lumbar spine. However, this is not practical, as we can’t hold our breath forever! Therefore, we must be able to activate our other deep core muscles to allow relaxed breathing.
Therefore, you may have the misconception that your core is strong because you do lots of ab work at the gym, which is not necessarily the case. The abs can be strong without the deeper core activating correctly, predisposing you to injury.
What do we do in Clinical Pilates at BeachLife Physio?
Our physios run private or two-on-one reformer classes, as well as small group mat work classes, with a maximum of five people.
A reformer is a piece of Pilates equipment that uses springs to provide resistance. The reformer can be used in many positions to work specific muscle groups as well as training the body to maintain a neutral position.
Mat classes mostly use body weight resistance in a wide variety of functional positions to target specific muscle groups. We use different pieces of equipment to further challenge stability and specific muscles. These classes focus on core activation, pelvic stability, posture and balance. It is more difficult to maintain neutral spine in mat work, and for this reason we recommend that beginners ad those with current pain start with reformer classes. Classes are tailored to your individual needs and an exercise program will be developed by a Physiotherapist to focus on YOU!
If you are interested in starting Pilates, please do not hesitate to contact us to discuss what class options would suit you best.
Call us on 9970 7982, or alternatively book online at beachlifephysio.com.
Cruz-Díaz, D., Martínez-Amat, A., Osuna-Pérez, M.C., De la Torre-Cruz, M.J., Hita-Contreras F. (2016). Short- and long-term effects of a six-week clinical Pilates program in addition to physical therapy on postmenopausal women with chronic low back pain: a randomized controlled trial. Disability Rehabilitation, 38 (13):1300-8.
Rydeard, R., Leger, A. and Smith D. (2006). Pilates- Based Therapeutic Exercise: Effect on Subjects With Nonspecific Chronic Low Back Pain and Functional Disability: A Randomized Controlled Trial. Journal of Orthopaedic & Sports Physical Therapy, 36(7):472-84.
Wells, C., Kolt, G., Marshall, P., Hill, B. and Bialocerkowski A. (2014). The Effectiveness of Pilates Exercise in People with Chronic Low Back Pain: A Systematic Review. PLOS One, 9(7).
Benefit: Low Impact
Walking and running on sand is lower impact than exercising on firm surfaces, which means less stress through weightbearing joints, such as the hips, knees and ankles. This decreases the risk of injuries caused by an overload of impact stresses, such as stress fractures, and is beneficial for people who need to limit the impact on their joints.
Risk: Injury Aggravation
Injuries and conditions where lower limb joints are unstable, such as ligament strains, may be aggravated by exercising on sand. In the long term many of these conditions will benefit from exercise on an unstable surface, but care must be taken to do the correct strengthening and balance exercises first to work up to the later stage of sand running.
Risk: Greater Fatigue
Exercising on sand will fatigue muscles faster. This may cause a loss of technique towards the end of the session, resulting in an increased risk injury. It is important to build up endurance by slowly increasing the load.
Take care to:
Slowly Increase Load
If this is a new type of exercise for you, slowly build up the time and distance you complete. Start with a short duration session, with mostly walking and a small amount of running, and then gradually build up endurance until you can run consistently.
Change Your Running Technique
Running on sand requires a change of technique to shorter and more frequent steps. Sand running requires more work and the pace is slower than on firm surfaces, so keep in mind that you won’t cover as much distance. When starting out with barefoot running, you will find muscles get sore in different areas, especially in the feet and ankles, as you move differently.
Select a Flat Beach
Some beaches are quite slanted. Running on an angle for a prolonged period causes uneven stresses on joints and may cause injury or pain. Select a level section of beach on which to complete your run or walk.
Look After Your Feet
Barefoot sand running and walking is great for strengthening muscles in the feet. However, most beaches are covered in debris such as shells, driftwood and unfortunately, rubbish. If running barefoot take care of where you step or select a clear section of beach.
If you want to start sand walking or running and need advice on any of the above please do not hesitate to book an appointment. Call us on 9970 7982, or alternatively book online at beachlifephysio.com.
Ferris, D.P., Liang, K., Farley, C.T. (1992). Runners adjust leg stiffness for their first step on a new running surface. European Journal of Applied Physiology and Occupational Physiology, vol. 65, iss. 2, pp. 183-7
Lejeune, T.M., Willems, P.A., Heglund, N.C (1998). Mechanics and Energetics of Human Locomotion on Sand. Journal of Experimental Biology, vol. 201, pp. 2071-80.
Pinnington, H.C., Dawson, B. (2001). The energy cost of running on grass compared to soft dry beach sand. Journal of Science and Medicine in Sport, vol. 4, iss. 4, pp. 416-30.
Pinnington, H.C., Lloyd, D.G., Briser, T.F., Dawson, B. (2005). Kinematic and electromyography analysis of submaximal differences running on a firm surface compared with soft, dry sand. European Journal of Applied Physiology, vol. 94, iss. 3, pp. 242-53.